Montelukast - good or bad?

Hi. I’m new here, looking in at the recommendation of the Asthma UK helpline nurse.

I’ve had asthma for most of my 58 years, but in the past 12 months things have deteriorated quite substantially, with 8 or 9 ambulances, multiple chest infections, gallons of salbutamol and several bucketfuls of prednisolone, and a gentle radioactive glow courtesy of multiple chest X-rays.

Two months ago I was introduced to Montelukast, and at first we got on famously. Blue inhalers in the bin and peak flow numbers to die for.

But then I discovered that Montelukast possibly has a dark side...........

Has anyone else here experienced the “1 in a 100” side effect of Montelukast? I’m talking about depression. As in curled up in a ball, floods of tears, screaming anguish, unbearable physical and emotional pain, suicidal-type depression.

I’ve been off Montelukast for three days now and this morning there’s a discernible difference to how I feel.

Of course my depression may be a consequence of the past 12 months of worsening asthma, but from what I’ve learnt, Montelukast is associated with the onset of depression.

I’d be very interested to hear from anyone else with similar experiences .

Thanks

Tim

[risabel59]

Hi there,

It is a definite possibility that you have had such a bad reaction to Montelukast. And nightmares, depression and headaches have all been linked to Montelukast in some people, I think (not sure about this figure) the odds of suicide and nightmares is about 20 times higher in those who take the drug than those who don't.

I have to say I take it, and I think it makes a difference to my asthma, but my only side effect is sometimes I get super vivid dreams, and think a lot of people do. The drug has been a life saver for my daughter who has taken it since she was 6.

However, people with asthma do get depression, but if you stopped the montelukast and are feeling much better, you have to believe that it is the cause. I would definitely go and see either your doctor or respiratory specialist and see if you can make alterations to your treatment to leave out Montelukast!!!

Best

R

[tk11]

I am on it have been for a while, I do take an antidepressant too and many many other cardiac drugs... Stick with it, helping me loads.

[IChoose]

I've been on montelukast 10 mg at bedtime since maybe 2001. It's a little wonder drug, and yes, im certain I experience the depressive side of it. I feel differently emotionally, etc. If I skip, but I also feel my allergies and asthma more. I too am lifelong respiratory disease and mid life.

Interesting, this year I learned I am low on immunoglobulin G by blood test. I am convinced this is also part of my life long illness.

FYI - I also take theophylline.

[zionfrost]

I don't get depressed from Montelukast but I sure get vivid dreams; so I never take it at night, always in the morning.

[garywake]

I have taken it for many years now and apart from a dry mouth I don't seem to have any side effects. Generally, my asthma has been well controlled but I had a bout recently that has sent me haywire. Getting better now though.

[Emer1000]

Singular is the main brand. Monteklaust is the generic. In Ireland we get Montklaust made in Iceland or Slovakia. Check the ingredients, there are slight differences. It is worth trying Monteklaust made in a diff location. I'm back on Singulair for 2 months after taking Monteklaust for 2 years. See which one suits you.

[Hidden in reply to Emer1000]

Thanks everyone. I've checked further into the Montelukast story, and yes, formulations do differ between manufacturers. Although the active ingredient stays the same, the excipients - the bulk of the tablet and the coating - are not always the same. I've learnt that it's very unlikely that the excipients would directly have any detrimental effect, although it's possible that they may influence the way in which the active ingredient is absorbed. I've been off Montelukast for a couple of weeks now, and my neuropsychiatric symptoms are substantially diminished. Since then I've also tracked down a very recent Dutch clinical paper that reviews published material from around the world. This does demonstrate an apparent link between Montelukast and a significantly increased incidence of depression, anxiety, nightmares, hallucinations, insomnia and suicidal thoughts.

There's no way that I'll ever try Montelukast or any similar-acting drug again. I just couldn't risk the potential consequences. I've lost a month or more of my life to a horrible dark depression and I do not ever want to go there again.

From what I've learnt I'm in an unlucky minority. There's no doubt the Montelukast is of benefit to the majority of those who take it, and I certainly wouldn't discourage anyone from giving it a try, if the asthma symptoms would seem to justify it. But equally, to an adult taking it I'd say that if you find your mood changing, or if the early depressive signs do start to appear then be prepared to bail out. To parents of Montelukast children I'd suggest that you watch your youngster closely, and if you see changes in behaviour, or hear about nightmares, or see aggression that previously wasn't there, then do consider the possibility that Montelukast could be responsible. I also think that if you have an established history of depression or anxiety, or possibly other long-term mental health issues, then Montelukast might be one to avoid. But of course, talk to the experts first - mine is the view of a single (and unlucky) lay-person!

Search the web for "Montelukast neuropsychiatric side effects" and you'll quickly find the Dutch paper. It was published only in September 2017, and reviews around 18,000 reports of neuropsychiatric side effects world-wide. The paper gives some scary numbers about the increased incidence of suicidal thoughts (over 20 times the "norm"), nightmares in children (around 30 times), and depression (7 times).

I don't blame anyone for what has happened to me. The GPs who prescribed Montelukast did so in good faith, and I'm sure that the manufacturers have done all they can to make the drug safe. My asthma has been of sufficient severity to justify blue lights and hospital stays, so it was definitely worth a try.

T

[Emer1000]

Singular is around a lot longer, I've taken it 20+ years on and off, Monteklaust is the generic, worth a Google, my daughter and friends daughter were prescribed it, expect there must be more research or certainly more known about it as it's available for longer. Might be worth a Google as same purpose as Monteklaust. Also dosage varies up to 10mg, so if you really needed it in the future might be handy to know about it.